A bridge between infertility and anxiety: a novel role for genes

Abstract

Abstract Background. Infertility can negatively affect mental health. Conversely, it is also hypothesized that psychological imbalance may exert a damaging influence on reproductive function. Unfortunately, until now it has been difficult to objectively explain these relations. Certain researchers suggest that genetic and epigenetic mechanisms could be factors. The aim of this study was to investigate the connection between infertility, anxiety and (or) depression by examining underlying genetics, so we can formulate future perspectives. Methods. The present study was conducted in few stages: (a) psychological assessment of females undergoing assisted reproductive technology (ART) procedure due to couple infertility, using the Hospital Anxiety and Depression Scale (HADS); (b) collection of endometrial samples before ART cycle from study participants; (c) isolation and cultivation of human endometrial-derived mesenchymal stromal cells (EnSCs); (d) analysis of 26 EnSCs’ genes by the reverse transcription-quantitative polymerase chain reaction (RT-qPCR): cell cycle regulation related (SLC39A1, RBM6, BLCAP, GATAD2B, RNF123, RECQL4), immune response related (AFF3, CD58, TNFSF4), signal transduction related (ESR1, CRTC2, CXCL8, PPP1R16A, NDN, GRB10, HTR2A, RB1, NR3C1, AXL), cell differentiation related (PAX8AS1, H19, EFNA5, IGF2), secretion related genes (MON1A, CYR61) and embryogenesis related genes (TFPI2); (e) statistical analysis; (f) summarization. Results. We investigated 32 females. 12 females expressed considerable symptoms of anxiety and 1 female showed symptoms of depression. 19 females conceived after ART procedures. Genetic analysis showed tendentious alterations in certain cell cycle regulation and transcription/translation, immune response, signal transduction, cell differentiation, secretion and embryogenesis process related gene expression according to female expression of anxiety. Moreover, it was observed that certain mechanisms could adversely affect pregnancy outcome after ART cycle or at least reflect it. Conclusions. It is known that infertility can have a harmful impact on a person’s psychology. However, a perception can be made that some tendencies such as anxiety may affect fertility even through the gene profile. The results we obtained encourage a deeper exploration of the relationship between fertility disorders, psychology and genes, as it does seem that qualified and timely psychological assessment, counselling and support could be one of the keys to raising pregnancy rates among infertile couples.